Laparoscopic Versus Open Nephrectomy : Clinical Effectivness and Cost Analysis

Inclusion Criteria: * American Society of Anesthesiology score 1-3. * Indication for : * Simple total nephrectomy or hemi nephrectomy: benign chronic inflammatory non-functioning kidney * Partial nephrectomy: localized renal mass ≤7 cm suitable for nephron-sparing surgery. * Radical nephrectomy or Radical nephrouretrectomy with bladder cuff: localized renal tumor requiring complete nephrectomy without major vascular invasion. * Patient deemed fit for general anesthesia and surgery. * Patient provides written informed consent. Exclusion Criteria: * emergency surgery, dialysis-dependent patients, planned hybrid procedures. * Patients with incomplete data * Patients with metastatic disease at presentation. * Prior extensive ipsilateral retroperitoneal surgery or severe adhesions precluding Laparoscopy. * Need for concomitant major procedures (eg, large bowel resection) at index operation. * Locally advanced tumor with obvious major vascular involvement requiring complex vascular reconstruction. * Uncorrected coagulopathy. * Pregnancy or Obese patient (BMI \> 40) * Inability to provide informed consent or comply with follow-up.